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AFTER SCHOOL - SAFETY SUPPORT
Parents,

Raising children, managing your household and work does not always run on a schedule that allows you to be in direct contact with your child’s school Administration Team, especially when safety issues arise. Often times, these issues will come to a parent’s attention well outside the school day with no reliable way to alert school Administration which is something our District wishes to provide added help

To provide appropriate assistance on behalf of your child, please provide the following information:

Email address *
Date of Incident *
MM
/
DD
/
YYYY
Bullied Individual(s) *
Your answer
Grade Level *
Location of the Incident *
Your answer
Individual(s) Who Bullied *
Your answer
Description of Bullying Behavior *
Your answer
Name of Witnesses *
Your answer
Do you or your friends feel unsafe? *
Person Reporting the Bullying *
Form Completed By... *
Your answer
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